DMAS to centralize member mail with 'Cardinal Care Correspondence Center' to meet CMS rules

Danielle Noll, operations lead for administration and coverage at the Department of Medical Assistance Services, described a phased plan to centralize inbound member mail and administrative returned mail under a new operation named the Cardinal Care Correspondence Center.

Noll said the change responds to a Centers for Medicare & Medicaid Services final rule (April 2024) requiring regular use of reliable data sources to identify address changes and a dual-modality approach to contacting beneficiaries when mail is returned. "Some of the requirements included in this final rule, are to, utilize reliable data sources," Noll said, listing examples such as yellow return-mail stickers, the National Change of Address (NCOA) database and confirmed updates from managed care organizations.

What DMAS will do: Noll said the agency will phase in the new centralized mailroom this summer by modifying the Cover Virginia contract with Maximus, which already operates a mail function for Cover Virginia. The phases described are:

- Phase 1 (inbound mail handling): new paper applications, mailed renewals, and returned verification documents will be routed to the centralized mailroom for scanning and bulk upload into the eligibility system. Noll said the contractor will scan and upload inbound documents and alert eligibility workers.

- Phases 2 and 3 (administratively returned mail): returned mail from the eligibility and enrollment systems (VACMS and MIS) will be processed, scanned and transferred into the case management system, with downstream automated and worker-driven workflows for address updates and beneficiary contact.

System and contract requirements: Noll said DMAS and Virginia Department of Social Services are making eligibility-system changes to support the mailroom, including an improved alert system, a worker dashboard, protections to prevent adverse automated case actions when documents are pending, and automated address-change processing when possible. The agency is pursuing access to NCOA and is building reporting to track dual-modality outreach attempts (phone, email, text or mail) and outcomes.

Contract performance windows and escalation: Under the contract modification described by DMAS, inbound applications and renewals must be scanned and routed to workers within two business days; pregnant women's applications will be handled within one business day. Return-verification documents and administratively returned mail will follow a two-business-day scan requirement. If returned mail includes a yellow forwarding sticker the contractor must resend mail within three business days; if no forwarding address is available, DMAS said the contractor must complete outreach via two modalities within five business days.

Implementation partners and oversight: Noll said DMAS is modifying its Cover Virginia contract with Maximus for the work and is consulting with GuideHouse. DMAS said it is meeting biweekly with VDSS, local agencies and other stakeholders to collect local-agency feedback and to coordinate changes to VACMS. Noll said the agency plans a phased rollout and expects additional system deployments timed to the project's readiness rather than a fixed date in May.

What DMAS said it will do next: DMAS said testing, additional system updates and local-agency training are planned before the mailroom goes live. Staff provided contact and escalation routes through Cover Virginia and the DMAS website for local agencies to raise operational questions.

Ending: DMAS emphasized that centralizing mail handling seeks to shorten processing times, reduce local-agency burden, improve tracking and help meet CMS requirements for maintaining accurate member contact information.